If you are currently employed, may we contact your present employer? *

Have you ever applied to this company before? *

If yes, where and when did you apply?

Are you willing to work overtime? *

U.S. Military or Naval Service

If driving is a requirement of the job you are applying for, do you have a current and valid driver's license? (If driving is a requirement of the job for which you are applying, continued employment is contingent on your maintaining a current driver's license.) *YesNo

If a minor, can you produce the age/work certificate necessary to obtain employment? *YesNo

Are you able, at the time of employment, to submit verification of your legal right to work in the U.S.? (Verification and completion of the I-9 form must be submitted no later than 3 business days after the date of hire.) *YesNo

Have you ever been convicted of a felony which is related to the functions or qualifications of the position for which you are applying? (NOTE: This question does not apply to convictions which have been sealed or expunged.) A conviction record will not necessarily be a bar from employment.*YesNo

If you have been convicted, describe fully the nature of the offense(s) and your rehabilitation since the conviction

List your last four employers, starting with your present or last place of employment.

1.Name and address of last employer *

Date From * To *

Salary Position Name of Supervisor

Reason for leaving:

2.Name and address of employer *

Date From * To *

Salary Position Name of Supervisor

Reason for leaving:

3.Name and address of employer *

Date From * To *

Salary Position Name of Supervisor

Reason for leaving:

4.Name and address of employer *

Date From * To *

Salary Position Name of Supervisor

Reason for leaving:

References

Give the names of three persons not related to you, whom you have known at least three years.

1.Name and Occupation *

Address *

Telephone Number * Years Known *

2.Name and Occupation *

Address *

Telephone Number * Years Known *

3.Name and Occupation *

Address *

Telephone Number * Years Known *

In signing this application, I certify that all of the foregoing information is a complete and accurate statement of the facts and understand that if any misrepresentation, omission or falsification be discovered, it will constitute grounds for dismissal. I hereby authorize you to conduct any investigation necessary concerning any part of my background related to the position I am seeking. I release all parties from any liability in connection with the provision and use of such information.
I understand and agree that, if employed by this organization, I will abide by its rules and regulations which I understand are subject to change. I further understand that, if hired, my employment is for no definite period of time and may be terminated by either party at any time.
P & L Heat Treating, Inc. is a drug free facility. Drug testing is required.